ABSTRACT
The aim of the study was to estimate clinical and functional indices under stable course of coronary heart disease (CHD) against the background of therapy with coraxan and atenolol. 95 patients (70 males and 29 females, average age 52.3 +/- 4.5 years) were observed. Addition of coraxan and atenolol to the standard therapy in patients with CHD made possible to improve patients" quality of life; tolerance to physical exercises was increased, and myocardial ischemia daily duration (MIDD) and number of ischemia episodes were decreased. Under the course coraxan therapy it was detected growth of ejection fraction and improvement of heart diastolic function. MIDD decrease accompanied improvement of indices, characterizing heart electrical instability.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Atenolol/therapeutic use , Coronary Disease/drug therapy , Coronary Disease/physiopathology , Angina Pectoris/drug therapy , Female , Humans , Male , Middle AgedABSTRACT
AIM: To assess ivabradin and nebivolol efficacy in combined treatment of ischemic heart disease patients with chronic heart failure (CHF) of functional class (FC) II-III by NYHA, impact of these drugs on quality of life, circadian indices of myocardial ischemia (CMI), left ventricular (LV) contractility. MATERIAL AND METHODS: A total of 92 patients with CHF of FC II-III (mean age 57.3 +/- 4.5 years) were randomized into 3 groups. Patients of group 1 (n = 30) received combined basic therapy: inhibitors of ACE, diuretics, aspirin, statins, on demand nitrates. Patients of group 2 (n = 33) received basic combined treatment plus nebivolol (nebilet, Berlin-Chemie/Menarini) in a dose 5.0 mg/day. Group 3 (n = 29) was given basic therapy plus ivabradin (coraxan) in a mean dose 7.5 mg. RESULTS: The addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction brought about control over heart rate (HR), improved quality of life, reduced severity of CHF, CMI, number of episodes of painful and painless ischemia. In reduced by nebivolol HR addition of ibavradin improved systolic and diastolic LV function. The analysis of HR variability in ivabradin administration showed enhancement of parasympathic activity in the vegetative balance. Administration of nebivolol produced modulated attenuation of sympathic activity. CONCLUSION: Addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction raises efficacy of treatment.
Subject(s)
Benzazepines/therapeutic use , Benzopyrans/therapeutic use , Ethanolamines/therapeutic use , Myocardial Ischemia/drug therapy , Vasodilator Agents/therapeutic use , Ventricular Dysfunction, Left/drug therapy , Benzazepines/administration & dosage , Benzopyrans/administration & dosage , Dose-Response Relationship, Drug , Drug Therapy, Combination , Echocardiography, Doppler, Color , Electrocardiography , Ethanolamines/administration & dosage , Follow-Up Studies , Humans , Ivabradine , Middle Aged , Myocardial Contraction/physiology , Myocardial Ischemia/complications , Myocardial Ischemia/physiopathology , Nebivolol , Platelet Aggregation Inhibitors , Stereoisomerism , Treatment Outcome , Vasodilator Agents/administration & dosage , Ventricular Dysfunction, Left/complications , Ventricular Dysfunction, Left/physiopathologyABSTRACT
AIM: To examine conduction system and repolarization in the ventricles and heart rate variability in hypertensive patients with consideration of 24-h blood pressure profile, left ventricular (LV) geometry and metabolic disorders. MATERIAL AND METHODS: 24-h monitoring of blood pressure, diagnostic transesophageal electrostimulation of the left ventricle, echocardiography were made and duration and dispersion of QT interval, variability of the intervals R-R (SDNN) were assessed in 73 untreated patients aged 42 to 57 years with essential hypertension of the second degree. RESULTS: It is shown that hypertensive patients having left ventricular hypertrophy (LVH), metabolic syndrome (MS) and pathologic 24-h blood pressure profile have also a depressed function of the sinus-atrial node and atrioventricular conduction, marked electric instability of the atria and ventricles. Such patients are at high risk to develop arrhythmia (3-5 times higher than patients without LVH, MS, with normal circadian blood pressure rhythm). CONCLUSION: Electric heart remodeling associated with LVH, MS and disturbances of circadian blood pressure pattern enhances electric instability and risk to develop cardiac arrhythmia.
Subject(s)
Blood Pressure/physiology , Electrocardiography , Heart Ventricles/diagnostic imaging , Hypertension/physiopathology , Metabolic Syndrome/complications , Ventricular Remodeling/physiology , Adult , Blood Pressure Monitoring, Ambulatory , Disease Progression , Echocardiography , Female , Heart Ventricles/physiopathology , Humans , Hypertension/complications , Hypertension/diagnostic imaging , Male , Metabolic Syndrome/physiopathology , Middle Aged , Prognosis , Sinoatrial Node/physiopathologyABSTRACT
Thirty patients with subclinical thyrotoxicosis and 32 with subclinical hypothyroidism with attacks of atrial fibrillation were investigated. At levels of thyroid-stimulating hormone below 0.1 or above 10.0 mIU/l average triiodothyronine and thyroxine levels in patients with subclinical thyrotoxicosis were 89.6 and 73.2%, respectively, higher than in patients with subclinical hypothyroidism. Some relationships were found between levels of thyroid hormones and hemodynamic and electrophysiological parameters of the heart. Differential therapy of attacks of atrial fibrillation was effective in 80 and 62.5% of patients with subclinical thyrotoxicosis or hypothyroidism, respectively.
